Organization
CHUGACHMIUT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEY BAKER (HEALTH SERVICES DIVISION DIRECTOR)
(907) 562-4155
Entity
Organization
Contact information
Practice address
1840 BRAGAW ST STE 110, ANCHORAGE, AK 99508-3463
(907) 562-4155
(907) 563-2891
Mailing address
1840 BRAGAW STREET, SUITE 110, ANCHORAGE, AK 99508
(907) 562-4155
(907) 278-0300
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
AK
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
AK
101YM0800X
Mental Health Counselor
—
AK
101YP2500X
Professional Counselor
—
AK
104100000X
Social Worker
—
AK
1041C0700X
Clinical Social Worker
—
AK
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1632379
—
AK
Enumeration date
08/10/2015
Last updated
12/08/2021
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